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As a parent, discovering that your baby boy has an undescended testis can be worrying. But this is one of the most common conditions seen in newborns — and with timely surgery, most children go on to have completely normal development, healthy testosterone levels, and good fertility. This guide explains everything you need to know, in plain language.
Male births affected at 6 months
Ideal age for surgery
Surgery success rate
During pregnancy, a baby boy’s testicles develop inside the abdomen. In the final weeks before birth, they travel down through a canal and settle into the scrotum — the pouch of skin behind the penis. When one or both testicles fail to complete this journey, the condition is called an undescended testis, also known by its medical name cryptorchidism.
The testicle may be located anywhere along its natural path — in the abdomen, in the groin canal, or just above the scrotum. In about 10% of cases, both sides are affected. The condition is more common on the right side.
An undescended testis is not your fault. There is no single known cause, and nothing done during pregnancy causes it. What matters most is early diagnosis and timely surgery — which has a success rate of around 98%. Your child can go on to live a completely normal life.
Undescended testis affects approximately 1 in every 100 male births at 6 months of age. It is significantly more common in premature babies — up to 30% of premature boys are born with this condition, as the testicles may not have had enough time to descend before early birth.
In some babies, the testicle descends on its own within the first few months of life. However, if it has not descended by 6 months of age, it is very unlikely to do so naturally, and surgery is required.
The diagnosis of undescended testis is straightforward and is made during a physical examination. The main sign is the absence of a testicle in one or both sides of the scrotum. There is usually no pain, and the condition does not affect your baby’s ability to pass urine.
Your doctor will examine your child and may arrange the following tests:
In cases where the testicle cannot be felt at all (impalpable testis), a laparoscopy — a keyhole procedure — is used both to locate the testicle and, in most cases, to perform the repair at the same time.
The exact cause is not fully understood. It is considered a multifactorial condition, meaning several factors may contribute. These may include:
There is no evidence that anything a mother does during pregnancy causes this condition.
The testicles need to be at a slightly lower temperature than the rest of the body to produce healthy sperm. Inside the abdomen, the temperature is too high, and over time this causes damage to the testicle tissue. This is why the timing of treatment matters significantly.
After 6 months of age, damage to an undescended testicle begins to occur gradually. The longer it remains outside the scrotum, the greater the risk to sperm-producing cells and future fertility. This is why all paediatric surgeons worldwide recommend surgery as early as possible — ideally at 6 months of age.
Surgery is the only medically proven treatment for undescended testis. Some traditional remedies or unqualified practitioners may claim that medication alone can correct the condition — this is not medically possible. The position of a testicle cannot be corrected with medicines.
The surgical procedure is called an orchiopexy (or orchidopexy). The surgeon locates the testicle, moves it into the correct position inside the scrotum, and secures it in place. Any inguinal hernia — which is very often present at the same time — is repaired during the same operation.
The ideal age for surgery is 6 months. Here is what the treatment timeline typically looks like:
| Age | What Happens |
|---|---|
| Birth | Diagnosis made during newborn exam. If testis not felt, condition noted. |
| 0–3 Months | Wait and watch. Testicle may descend naturally in premature babies. |
| 3 Months | Re-examination. If still undescended, surgery planned for 6 months. |
| 6 Months | Ideal age for surgery (orchiopexy). Best outcomes at this age. |
| After 6 Months | Surgery still possible and strongly recommended. Earlier is better. |
| 12–24 Months | Latest recommended window for surgery if not already done. |
If the testicle can be felt in the groin (palpable), a single-stage open surgery is usually performed. If the testicle is inside the abdomen and cannot be felt (impalpable), the surgery is done laparoscopically — using a small camera through tiny incisions in the abdomen. This may be done in one or two stages, depending on the location of the testicle and the surgeon’s assessment.
With timely surgery at the recommended age, most boys with a single undescended testis grow up to have normal fertility — similar to boys without the condition. Boys with both testicles affected (bilateral undescended testis) have a lower, but not zero, chance of fathering children, especially if treatment is delayed.
Early surgery significantly reduces the risks. This is one of the most important reasons to act promptly.
It is worth knowing the difference between these two conditions, as they are sometimes confused:
Your paediatric surgeon will be able to distinguish between the two during examination.
In some babies — particularly premature ones — the testicle may descend on its own within the first three to six months of life. However, if it has not descended by 6 months of age, it will not do so naturally. Surgery is then required. No medication can move a testicle into position.
No — an undescended testis itself does not cause pain in babies or young children. There are usually no symptoms other than the absence of the testicle in the scrotum. However, if your child is in pain in the groin area, this could indicate testicular torsion or a hernia, which are emergencies. See a doctor immediately.
With surgery performed at the recommended age (ideally 6 months), most boys with one undescended testis have normal fertility as adults. Boys with both testicles affected have a lower fertility rate, but early surgery significantly improves their chances. The key is not to delay treatment.
Yes, there is a slightly higher lifetime risk of testicular cancer compared to the general population. However, early surgery reduces this risk. As your son reaches his teenage years, he should be taught to perform monthly self-examinations and have regular check-ups with a doctor. Testicular cancer, when caught early, is highly treatable.
An undescended testis means the testicle has not moved into the scrotum. An inguinal hernia is a separate condition where part of the intestine pushes through a weakness in the abdominal wall near the groin. The two conditions often occur together in the same child. When they do, both are corrected in the same surgery — there is no need for two separate operations.
Undescended testis surgery at KidsCare Hospital Rawalpindi is performed by our specialist paediatric surgical team. Dr. Muhammad Umar Nisar is a Neonatal, Paediatric & Laparoscopic Surgeon with over 15 years of experience
KidsCare Hospital Rawalpindi is a leading paediatric surgical centre serving families across Rawalpindi, Islamabad, and the wider region. Our paediatric surgeons are experienced in all types of orchiopexy — from routine single-stage repairs to complex two-stage laparoscopic procedures for intra-abdominal testes. We offer a dedicated child-friendly environment, modern surgical facilities. Parents trust KidsCare Hospital because we treat every child as our own — with expertise, care, and transparency at every step.
